Caecal adenocarcinoma metastatic to ovary inducing increased oestrogen production and postmenopausal bleeding

This report describes a patient with a primary caecal adenocarcinoma metastatic to the right ovary, who presented with postmenopausal bleeding secondary to neoplastically induced excessive ovarian steroid production. Histopathological, electron microscopical, tumour tissue incubation and various endocrinological studies were performed to investigate the hormonal basis of this presentation. It is concluded that the elevated oestrogen levels responsible for the postmenopausal bleeding were not of direct ovarian origin, but were consequent upon nonovarian conversion of oestrogen precursors produced by tumour induced hyperplastic ovarian stromal tissue.